STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

STD Awareness: Is Syphilis Making a Comeback?

men syphilisBefore antibiotics, syphilis was the most feared sexually transmitted disease (STD) out there. It was easy to get, quack cures were ineffective and often unpleasant, and it could lead to blindness, disfigurement, dementia, or even death. When we were finally able to zap infections away with drugs like penicillin, it seemed like we’d finally won the battle against this scourge. Whereas syphilis rates were highest before antibiotics became widespread in the 1940s, by 2000 we saw a low of 2.1 cases of syphilis per 100,000. At the dawn of the new millennium, many scientists thought the United States was at the dawn of the complete elimination of syphilis.


Using condoms, regular STD testing, and limiting sex partners are the best ways for sexually active people to stay healthy.


Must all good things come to an end? They shouldn’t have to, but in the case of syphilis, the Centers for Disease Control and Prevention (CDC) has announced that syphilis rates are rising, with incidence doubling since 2005. In the United States, there are now 5.3 cases of syphilis per 100,000 people, but that number is a bit misleading because it represents an average across the general population. When you break the population down by age, race or ethnicity, gender, or sexual orientation, that rate might be much higher or much lower. For example, syphilis rates are actually on the decline among women (at only 0.9 cases per 100,000), but among men it is 9.8 per 100,000. In fact, most new syphilis cases — 91.1 percent of them, to be precise — are in men, most of whom are gay or bisexual.

Syphilis is rising the most dramatically among men in their twenties, especially among men who have sex with men (MSM). While some wonder if syphilis is growing among twenty-somethings because this group didn’t live through the early era of AIDS, when HIV was seen as a death sentence and safer sex practices were more common, it might also be due to the fact that STD rates are higher among young people in general. Continue reading

STD Awareness: Asymptomatic Shedding of Herpes

Q: Can I catch herpes if my partner isn’t having an outbreak?
A: Yes, your partner can transmit the virus even if he or she isn’t experiencing symptoms. In fact, most genital herpes infections are transmitted in the absence of symptoms.

When most people think about genital herpes, they think about the symptoms that are associated with it: clusters of blistery sores around the genitals or buttocks. But most genital herpes infections don’t have symptoms — they are asymptomatic — or the symptoms are so mild or nonspecific that the person suffering from them doesn’t even make the mental connection. It is estimated that only 10 to 15 percent of people with herpes exhibit symptoms, which may be a silver lining for the millions who unknowingly carry the virus, but it also helps it spread more easily.

What is genital herpes, anyway?

Genital herpes can be caused by two types of herpes simplex viruses — either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). The difference between the two viruses is that HSV-1 is more active when it infects the facial region, where it can cause cold sores; HSV-2 is more active when it infects the genitals. Genital infections with HSV-1 tend to be milder than genital infections with HSV-2. The Centers for Disease Control and Prevention states that, among Americans 14 to 49 years old, 1 out of 5 women and 1 out of 9 men have a genital HSV-2 infection. Because that stat doesn’t count genital HSV-1 infections, the overall number of people with genital herpes is actually higher.

An “outbreak” occurs when genital herpes symptoms appear. The most well-known symptom is a cluster of blisters or open sores in the genital or rectal area. Continue reading